tv U.S. Senate Votes to Proceed to Debate on Health Care Bill CSPAN July 25, 2017 2:15pm-4:16pm EDT
to gavel back in to take up the motion to proceed voting to begin debate on the healthcare law. the democrats and republicans have been in their weekly conference meeting and during those meetings we heard on twitter and from a number of reporters saying that dean heller plans to vote yes as does senator rob portman of ohio. the majority leader mitch o'connell will come to the senate floor, make comments on the floor and step out to speak with reporters as we are able we will have it live for you hear on c-span2. ficer: the majority leader. mr. mcconnell: i ask unanimous consent the democratic leader be recognized for five minutes for debate only and that i then be recognized. the presiding officer: is there objection? without objection.
mr. schumer: mr. president. the presiding officer: the democratic leader. mr. schumer: mr. president, in
a short time we'll vote on the motion to proceed to debate the house republican health care bill. several months into this new process with republicans in the majority in both chambers, the american people have not been treated to a high-minded debate, or much debate at all. the very first action of this congress was for the majority to pass reconciliation instructions on health care, a process which is locked -- has locked out democrats from the very beginning. the very first thing this republican congress said to the american people is that health care is going to be a partisan project undertaken by republicans and republicans alone. right out of the gate, democrats were locked out. the majority leader elected to
tens of millions, health, and even life affected without knowing exactly what we'll be debating on. perhaps nothing could sum up the processs that gotten -- that's gotten us here quite as well as this. now, the best the majority leader's been able to cook up is a vague plan to do whatever it takes to pass something, anything, to get the bill to a house and senate conference on health care. my colleagues, plain and simple, it's a ruse. the likeliest result of a conference between the house and senate is full repeal of the affordable care act or something very close to it. it will certainly mean drastic cuts in medicaid, huge tax cuts for the wealthy, no help for those with preexisting
conditions, and tens of millions losing health care, particularly in more rural states. the hard-right freedom caucus in the house would never accept a republican bill that only appeals a few of -- affordable care act. and i say to those on the other side of the i'll who fought to not cut medicaid drastically, for keeping preexisting conditions, for not cutting tax cuts to the rich, don't go along with this motion to proceed. you know and i know what it will lead to. all of the things you have been trying to avoid will emerge from that conference and you will hurt the people of your states dramatically. we all know what's happening here. the leader could not get the
votes on full repeal because it's so damaging to america. he could not get the votes even on his own bill. so instead the plan is to come up with a proposal that is simply a means to repeal, a means to dramatic cuts, a means to getting us in conference, and we all know what the result of that conference would be. i will plead one last time with my friends on the other side of the aisle, and i know you have sincerely tried to modify and change things. turn back. we can go through regular order. we can work with you. we know that a.c.a. is not perfect, but we also know what you've proposed is much worse. we can work together to improve health care in this country. turn back now before it's too late and millions and millions
and millions of americans are hurt so badly in ways from which they will never, ever recover. i yield the floor. mr. mcconnell: mr. president. the presiding officer: the majority leader. mr. mcconnell: seven years ago -- seven years ago democrats imposed obamacare on our country. they said costs would go down. costs skyrocketed. they said choice would go up. choice plummeted. now obamacare's year's long lurch toward total collapse is nearing a seemingly inevitable conclusion, and will -- and it will hurt even more americans on the way down. this, my friends, is the obamacare status quo. this is the status quo.
we had to accept it for a long time. we don't have to accept it any longer. the american people elected a house with a vision with a better way on health care, and then they elected a senate and then they elected a president. now, having been given the responsibility to govern, we have a duty to act. the president's ready with his pen. the house has passed legislation. today it's the senate's turn. that starts with the vote we'll take momentarily. it's the critical first step in that process, the motion to
proceed. it's the vote that determines whether this debate can proceed at all, whether we'll even take it up. after four straight elections in which this was a huge commitment to the american people. it's the vote that determines whether senators of both parties can offer their amendments and ideas on health care. well, i told the people of my state over this period that i'd vote to move beyond obamacare, and that's what i'm going to do today by voting yes, and i would ask all of my colleagues to join me in doing so. we've already shown it's possible to put legislation on the president's desk that moves
us beyond obamacare and its years of failure. we did that two years ago. president obama vetoed what we passed before. president trump will sign what congress passes this time. i want to thank the president and the administration for all they've done on this issue already. they worked with us every step of the way and they, like us, know the consequences of failing to act. look, we can't let this moment slip by. we can't let it slip by. we talked about this too long. we've wrestled with this issue. we've watched the consequences of the status quo. the people who sent us here expect us to begin this debate. to have the courage to tackle a
tough judiciary. they didn't -- tough issue. they didn't send us here to do just the easy stuff. they expect us to tackle the big problems, and obviously we can't get an outcome if we don't start the debate, and that's what the motion to proceed is all about. many of us on this side of the aisle have waited years for this opportunity and thought it would probably never come. i'm also -- i was also a little surprised by the election last year, but with a surprise election comes great opportunities to do things we thought were never possible. so all we have to do today is to have the courage to begin the debate with an open amendment process and let the voting take
us where it will. sos that what's -- so that's what's before us, colleagues. will we begin the debate on one of the most important issues confronting america today? it's my hope the answer will be yes. now, mr. president, i ask unanimous consent that following the votes, -- vote, senator mccain be recognized to speak for debate only for up to 15 minutes and that the time not count on h.r. 1628. the presiding officer: is there objection? no objection is heard. mr. mcconnell: mr. president, i move to proceed to calendar number 120, h.r. 1628. the presiding officer: the clerk will report. the clerk: motion to proceed to calendar number 120, h.r. 1628, an act to provide for
reconciliation pursuant to title 2 on the budget for fiscal year 2017. mr. mcconnell: i ask for the yeas and nays. i ask for the yeas and nays. the presiding officer: the sergeant at arms will restore order in the chamber. sergeant at arms will restore order in the chamber, please. the presiding officer: the sergeant at arms will restore order in the chamber.
the vice president: as a a remired to our guests, expression of apaul or disa approval are not permitted. on this vote, the yeas are 50, the nays are 50. the senate being equally divided, the vice president votes in the affirmative, and the motion is agreed to. the clerk will report the bill. the clerk: calendar number 120, h.r. 1628, an act to
provide for reconciliation pursuant to title 2 of the concurrent resolution on the budget for fiscal year 2017. the vice president: the senior senator from arizona is recognized. mr. mccain: i thank you, mr. president. i've stood in this place many times and addressed this president, many presiding officers. i've been so addressed what i've senate that chair. that's as close as i'll ever to be a presidency. anyway, it's an honor we're almost indifferent to, isn't it? presiding over the senate can be a nuisance, a bit of ceremonial bore. it is usually relegated to the more junior members. but i stand here today looking a little worse for the wear, i am a sure. i have an appreciation for the protocols and customs of this body and for the other 99
privileged souls who have been elected to this senate. i have been a member of the united states senate for the 39 years. i had another long, if not as long, career before i arrived here, another profession that was profoundly rewaterboarding and which i had experiences and friendships that i revere. but make no mistake, my service here is the most important job i've had in my life. i'm so grateful -- so grateful to the people of arizona for the privilege, for the honor of serving here and the opportunities it gives me to play a small role in the history of the country that i love. i've known and admired men and women in the senate who played much more than a small role in our history, true statesmen, giants of american politics that come from both parties and from various backgrounds. their ambitions were frequently in conflict. they held different views on the issues of the day, and they
often had very serious disagreementdisagreementsdisagro serve the national interest. but they knew that however sharp and heartfelt their disputes, however keen their ambitions, they had an obligation to work collaboratively to ensure the senate discharged its constitutional responsibilities effectively. our responsibilities are important, vitally important to the continued success of our republic. our arcane rules and customs are deliberately intended to require broad cooperation to function well at all. the most revered members of this institution accepted the necessity of compromise in order to make incremental progress on solving america's problems and defend her from her adversaries. that principle mind-set and the service of our predecessors who possessed it come to mind when i
hear the senate referred to as the world's greatest deliberative body. i'm not sure we can claim that distinction with a straight face today. i'm sure it wasn't always deserved in previous eras either, but i'm sure there have been times when it was, and i was privileged to witness some of those occasions. our deliberations today -- not just our debates, but the exercise of all of our responsibilities -- authorizing government policies, appropriating the funds to implement them, exercising our advice and consent role, are often lively and interesting. they can be sincere in principle, but they're more partisan, more tribal, more of the time than at any time than i can remember. our deliberations can still be important and useful. but i think we'd all agree, they haven't been overburdened by greatness lately.
like now, they aren't producing much for the american people. both sides have let this happen. let's leave the history of who shot first to the historians. i suspect they'll find we all conspired in our decline, either by deliberate actions or neglect. we've all played some role in it. certainly i have. sometimes i've let my passion rule my reason. sometimes i made it harder to find common ground because of something harsh i said to a colleague. sometimes i've wanted to win more for the sake of winning than to achieve a contested policy. incremental progress, compromises that each side criticized but also accept, just plain muddling through to chip away at problems and keep our enemies from doing their worst isn't glamorous or exciting. it doesn't feel like a political triumph. but it's usually the most we can expect from our system of
government, operating in a country as diverse and quarrelsome and free as ours. considering the injustice and cruelties inflicted by autocratic governments and how corruptible human nature can be, the problem-solving our system does make pork the fitful frog produces and the liberty and justice it preserves is a magnificent achievement. our system doesn't depend on our nobility. it accounts for our imperfections and gives us an order to our individual strivings that has helped make ours the most powerful and prosperous society original. it is our responsibility to preserve that, even when it requires us to do something less satisfying than winning, even when we must give a little to get a little, even when our efforts managed just three yards in a cloud of dust aallow critics on both sides to
announce us for our failure to triumph. i hope we can again rely on humility on our need to cooperate, on our dependence on each other, learn how to trust each other again and by so doing better serve the people who elected us. stop listening to the bombastic loud mouths on the radio, television and internet. to hell with them. they don't want anything done for the public good. our incapacity is their livelihood. let's trust each other. let's return to regular order. we've been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle. that's an approach that's been employed by both sides, mandating legislation from the top down without any support from the other side, with all the parliamentary maneuvers that requires.
we're getting nothing done, my friends. we're getting nothing done. all we've really done this year is confirm neil gorsuch to the supreme court. our health care insurance system is a mess. we all know it. those who support obamacare and those who oppose it. something has to be done. we republicans have locked for a way to end -- have looked for a way to end it and replace it with something else without paying a terrible political price. we haven't found it yet and i'm not sure we will. all we've managed to do is make more popular a policy that wasn't very popular when we started trying to get rid of it. i voted for the motion to proceed to allow debate to continue and amendments to be offered. i will not vote for this bill as it is today. it's a shell of a bill right now. we all know that. i have changes urged by my state governor that will have to be included for my support of final
passage of any bill. i know many of you will have to see the bill change ?anl for you to -- substantially for you to support it. we try to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them that it's better than nothing. that it's better than nothing? asking us to swallow our doubts and force it passed a unified opposition. i don't think that's going to work in the end, and probably shouldn't. the administration and congressional democrats shouldn't have forced through congress without any opposition or support a social economic change as massive as obamacare. and we shouldn't do the same with ours. why don't we try the old way of legislating in the senate? the way our rules and customs encourages us to act. if this process ends in failure, which seems likely,
then let's return to regular order. let the health, education, labor and pensions committee under chairman alexander and ranking member murray hold hearings, try to report a bill out of committee with contributions from both sides. something that my dear friends on the other side of the aisle didn't allow to happen years ago. let's see if we can pass something that will be imperfect, full of compromises and not very pleasing to implacable promises on the other side but that might provide workable solutions americans are struggling with today. what have we to lose by trying to work together to find those
solutions? we're not getting done much apart. i don't think any of us feels very proud of our incapacity. merely preventing your political opponents from doing what they want isn't the most inspiring work. there's greater satisfaction in respecting our differences but not letting them prevent agreements that don't require abandonment of core principles, agreements made in good faith, that help improve lives and protect the american people. the senate is capable of that. we know that. we've seen it before. i've seen it happen many times, and the times when i was involved even in a modest way with working on a bipartisan response to a national problem or threat are the proudest moments of my career, and by far the most satisfying. this place is important. the work we do is important. our strange rules and seemingly
he can century practices that -- eccentric practices that slow our proceedings are important. the founders envisioned the senate as the more deliberative careful body that operates at a greater distance from the public body from the passions of the hour. we are a check on the powers of the executive. our consent is necessary for the president to appoint jurist and powerful government officials and in many respects to conduct foreigner policy. whether or not we are of the same party, we are not the president's subordinates. we are his equal. as his responsibilities -- as his responsibilities are onerous, many in powerful, so are ours. we play a vital role in shaping and directing the military and the cabinet in forming domestic policies, our success in meeting all these awesome constitutional obligations depends upon cooperation among
ourselves. the success of the senate is important to the continued success of america. this country, this big, boisterous, sprawling, con temperate, daring, beautiful, bountiful, brave, good and magnificent country needs us to help it thrive. that responsibility is more important than any of our personal interests or political affiliation. we are the servants of a great nation, a nation conceived in liberty and dedicated to the top position that all men are created equal. more people are free, have lived free and prosperous lives here than in any other nation. we've acquired unprecedented wealth and power because of our governing principles and because our government defended those principles. america has made a greater contribution than any other nation to an international order
that has liberated more people from tyranny and poverty than ever before in history. we have been the greatest example, the greatest supporter and the greatest defender of that order. we aren't afraid. we don't covet other people's land and wealth. we don't hide behind walls. we bridge them. we are a blessing to humanity. what greater cause could we hope to serve than helping keep america the strong, inspiring, inspirational beacon of liberty and defender of dignity of all human beings and their right to freedom and equal justice? that is the cause that binds us, and is so much more powerful and worthy than the small differences that divide us. what at great honor and extraordinary opportunity it is to serve in this body. it's a privilege to serve with all of you.
i mean it. many of you have reached out in the last few days with your concern and your prayers, and it means a lot to me. it really does. i've had so many people say such nice things about me recently that i think some of you must have me confused with someone else. i appreciate it, though, every word of it, even if much of it isn't deserved. i'll be here for a few days. i hope managing the floor debate on the defense authorization bill which i'm proud to say is again a product of bipartisan cooperation and trust among the members of the senate armed services committee. after that, i'm going home for awhile to treat my illness. i have every intention of returning here and giving many of you cause to regret all the nice things you said about me. and i hope to impress upon you again that it is an honor to serve the american people in
mr. mcconnell: i ask unanimous consent the reading of the amendment be dispensed with. mrs. murray: mr. president, i object. the presiding officer: is there objection? objection is heard. the clerk will read the amendment. the clerk: and insert the following: one, short title. this act may be cited as the obamacare repeal reconciliation act of 2017. title 1, section 101, recapture excess advance payments of premium tax credits. subparagraph b of section 36-b-f-2 of the internal revenue code of 1986 is amended by adding at the end the following new clause. three, nonapplicability of limitation. this subparagraph shall not apply to taxable years ending after december 31, 2017, and before january 1, 2020. section 102, premium tax credit. a, premium tax credit.
one, repeal. a, in general subpart c of part 4 of subchapter a of chapter 1 of the internal revenue code of 1986 is amended by striking section 36-b. b, effective date. the amendment made by this paragraph shall apply to taxable years beginning december 31, 2019. b, repeal of eligibility determinations. one, in general the following sections of the patient protection and affordable care act are repealed. a, section 1411, other than subsection 1, the last sentence of subsection a-4-a-2 and such provisions of such sections solely to the extent related to the application of the last sentence of subsection e-4-a-2, b, section 1412, two effective
date. the repeals in paragraph one shall take effect on january 1, 2020. c, protecting americans by repeal of dis closure authority to carry out eligibility requirements for certain programs. one, in general, paragraph 21 of section 6103-1 of the internal revenue code of 1986 is amended by adding at the end the following new subparagraph. d, termination. no disclosure may be made under this paragraph after december 31, 2019. two, effective date. the amendment made by paragraph 1 shall take effect on january 1, 2020. section 103, small business tax credit. a, sunset. one, in general, section 45-r of the internal revenue code of
1986 is amended by adding at the end the following new subsection: j, shall not apply. this section shall not apply with respect to amounts paid or incurred in taxable years beginning after december 31, 2019. two, effective date. the amendment made by this subsection shall apply to taxable years beginning after december 31, 2019. section 104, individual mandate. a, in general, section 5000a-c of the internal revenue code of 1986 is amended. one, in paragraph 2-b-3 by striking 2.5% and inserting zero percent. and two, in paragraph three, a, by striking $695 in subparagraph a and inserting
zero dollars. and b, by striking subparagraph d. b, effective date. the amendments made by this section shall apply to months beginning after december 31, 2015. section 105, employer mandate. a, in general, one, paragraph one of section 14 of 1986 is amended by inserting zero dollars in the case of months beginning after dees 31, 2015, after $2,000. two, paragraph one of section 4980, h-b is amended by inserting zero dollars in the case of months beginning after december 31, 2015.
b, effective date. the amendments made by this section shall apply to months beginning after december 31, 2015. section 106, federal payments to states. a, in general, notwithstanding section 504-a, 19012-a, 1903-a, 2002, 2005-a-4, 2102-a-7, or 2105-a-1 of the social security, 42, u.s.c., 1394a, 1396-b, 1397-a, 1397d-a-4, 1397e-e-a-1,
or the terms of any medicaid waiver in effect on the date of the enactment of this act that is approved under section 115 or 1915 of the social security act 42-usc-1315, for the one-year period beginning on the date of this enactment of this act, no federal funds provided for a program referred to in this subsection that is considered direct spending for any year may be made available to a state for payments to a prohibited entity.
the presiding officer: the sergeant at arms will restore order in the gallery. the presiding officer: the clerk may continue. the clerk: rather made to the prohibited entity or managed care organization under contract with the state. b, definitions. in this section, one, prohibited entity. the term prohibited entity means an entity, including its
affiliates, subsidiaries, successors and clinics. a, that as of the date of enactment of this act, one, is an organization described in section 501-c-3 of the internal revenue code of 1986 and exempt from tax 501-a of such code. two, is an essential community provider described in sections 156.235, code of federal regulations, as in effect on the date of enactment of this act. that is primarily engaged in family planning services, reproductive health and related medical care and, three, provides for abortions other than abortion, one, if the pregnancy is the result of an -- of an act of rape or insist or, two, in a case where a woman suffers from a physical disorder
or physical illness that would, as certified by a physician, including a life-endangering physical condition caused by or arising from the pregnancy itself. and, b, for which the total amount of federal and state expenditures under the medicaid program under title 19 of the social security act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors or clinics of the entity or made to the entity and to any affiliates, subsidiaries, successors or clinics of the entity as part of the nationwide health care network exceeded $1 million. two, direct spending. the term direct spending has meaning given that term under section 250-c of the balance
budget emergency deficit control act of 1985, two, usc, section 107, medicaid. the social security act 42-usc-301, is amended. one, in section 192, a, in subsection 10-a-10 in each of the clauses one 8 and 220, which inserting and ending december 31, 2019 after january 1, 2014, and b, in subsection a-47-b by inserting and providing that any such elections shall cease to be effective on january 31, 2020, and no such election shall be made after that date before the semi-colon at the end. two, in the first sentence of
subsection b, by inserting 50% on or after january 1, 2020, after 55%. b, in subsection y-1, by striking the semi-colon and all that follows through thereafter, and c, in subsection z, by inserting through 2019 after each year thereafter and, two, in subparagraph b-26, by striking in each subsequent year. in three, in section 1915-k-2, by striking in paragraph one and inserting on or after the date referred to in paragraph one or before january 1, 2020.
in subsection-e, by adding at the end the following, this subsection shall not apply after december 31, 2019. five, in section 1937-5-b, this shall not apply after december 31, 2019, and, six, in section 1943-a, by inserting and before january 1, 2020, after jab january 1, 2014. section 108, repeal of dsh allotment reductions, section 1920-f, of the social security act 42-usc-r or f is amended by striking paragraph seven and eight. section 109, repeal on the tax of employ premiums and benefits. a, in general, chapter 43 of the
internal revenue code of 1986 is amended by striking section 4980-i. b, effective date, the amendment made by subsection a shall apply to taxable years after december 31, 2019. c, subsequent effective date, the amendment made by subsection a shall not apply to taxable years beginning after december 31, 2025, and chapter 43 of the internal revenue code of 298 -- 1986 is amended to read as much chapter is read if such subsection had never been enacted. section 110, repeal of tax on over-the-counter medications. a, hsa, subparagraph a of 32-2-2 is amended by striking such term
and all that follows through the period. b, archer, subparagraph a of internal revenue code of 1986 is amended by striking such term and all that follows through the period. c, health flexible spending arrangements and health reimbursement arrangements. sections 106 of the internal revenue code of 1986 is amended by striking subsection f. d, effective dates. one, distributions from savings accounts. the amendments made by subsection a and b shall apply to amounts paid with respect to taxable years beginning after december 31, 2016. two, reimbursements. the amendment made by subsection c shall apply to expenses incurred with respect to taxable years beginning after
december 31, 2016. section 111-a, section 223-f-4-a of the internal revenue code of 1986 is amended by striking 20% and inserting 10%. b, archer m.s.a.'s, section 220-f-4-a of the internal revenue code of 1986 is amended by striking 20% and inserting 15%. c, the amendments made by this section shall apply to is distributions made after december 31, 2016. section 112, repeal of limitations on contributions to flexible spending accounts. a, in general. section 125 of the internal revenue code of 1986 is amended
by striking section one. b, effective date. the amendment made by this section shall apply to planned years beginning after december 31, 2017. section 113, repeal of tax on prescription medications. subsection j of section 9008 of the patient protection and affordable care act is amended to read as follows, j, repeal, this will apply to calendar years after december 31, 2010, and ending before january 1, 2018. section 114, repeal of medical device excise tax. section 4191 of the internal revenue code of 1986 is amended by adding at the end the following new subsection, d
applicability, the tax imposed under subsection a shall not apply to sales after december 31, 2017. section 115, repeal of health insurance tax. subsection j of section 9010 of the patient protection and affordable care act is amended by striking and at the end of paragraph one and all that follows through 2017. section 116, repeal of elimination of deduction for expenses applicable to medicare part d subsidy, a, in general, section 139-a of the internal revenue code of 1986 is amended by adding at the end the following nuisance. this -- nuisance. this will not be taken into account by determining any deduction is allowable in
determining such payment. b, effective date. the amendment made by this section shall apply tookable years beginning after -- to taxable years beginning after december 31, 2016. section 117, repeal of chronic care tax, a, in general, subsection a of section 213 of the internal revenue code of 1986 is amended by striking 10% and inserting 7.5%. b, effective date. the amendment made by this section shall apply to taxable years beginning after december 31, 2016. section is 1 -- section 118, repeal of medicare tax increase. a, in general, subsection b of section 3101 of the internal revenue of 1986 is amended to read as follows, b, hospital insurance, in addition to the
tax imposed by the preceding subsection there is hereby imposed on the income of every individual a tax equal to the 1.45% of wages as defined in section 3121-a, as received by such individual with respect to employment as defined in section 3121b. subsection b of section 1401 of the internal revenue code of 1986 is amended to read as follows, b, hospital insurance. in addition to the tax imposed by the proceeding subsection, there shall be imposed for each taxable year on the self-employment income of every individual a tax equal to 2.9% of the amend of the self-employment income for such taxable year. c, effective date, the amendments made by this section shall apply with respect to
renumeration received after in taxable years beginning after december 31, 2017. section 119, repeal of tanning tax. a, in general the internal revenue code of 1986 is amended by striking chapter 49. b, effective date, the amendment made by this section shall apply to services performed after september 30, 2017. section 120, repeal of net investment tax. a, in general, subtitle a of the internal revenue code of 1986 is amended by striking chapter 2-a. b, effective date, the amendment made by this section shall apply to taxable years beginning after december 31, 2016. section 121, renumeration, paragraph six of section 162 of
the internal revenue code of 1986 is amended by adding at the end the following subparagraph, 1, termination, this paragraph shall not apply to taxable years beginning after december 31, 2016. title 2, section 201, the prevention and public health fund. subsection b of section 4002 of the patient protection and affordable care act, 42-usc-300-u-11 is amended. one nrks paragraph three, by striking each of fiscal years 2018 and 19 and inserting fiscal year 2018. and, 2, by striking paragraphs four through eight. section 202, support for state response to substance abuse public health crisis and urgent mental health needs.
a, in general, there are authorized to be appropriated and are appropriated out of moneys in the treasury not otherwise obligated, $750 million for each of the fiscal years 2018 and 2019 to the secretary of health and human services, referred to in this section as the secretary to award grants to states to address the substance abuse public health crisis or to respond to urgent mental health needs within the state. in awarding grants under this section, the secretary may give preference to states with an incidence or prevalence of substance use disorders that is substantial relative to other states or to states that identify mental health needs within their communities that are urgent relative such needs of other states. funds appropriated under this subsection shall remain available until expended. b, use of funds.
grants awarded to a state under subsection a shall be used for one or more of the following public health related activiti activities, one, improving state prescription drug monitoring programs. two, implementing prevention activities and evaluating such activities to identify effective strategies to prevent substance abuse. three, training for health care practitioners, such as best practices for prescribing opioids, pain management, recognizing potential cases of substance abuse, referral of patients to treatment programs, and overdose prevention. four, supporting access to health care services provided by federally certified opioid treatment programs or other appropriate health care providers to treat substance use disorders or mental health needs. five, other public
health-related activities. as the states determine appropriate related to addressing the substance abuse public health crisis or responding to urgent mental health needs within the state. section 203, community health center program. effective as if included in the enactment ever the medicare access and chip reauthorization act of 2015, public law 114-10-129-87 paragraph one of section 221-a of such act is amended by inserting an additional $422 million for fiscal year 2017 after 2017. section 204, funding for cost-sharing payments. there is appropriated to the secretary of health and human services out of any money in the
treasury not otherwise appropriated such sums as may be necessary for payments for cost-sharing reductions by the patient protection and affordable care act, including adjustments to any prior obligation for such payments for the period beginning on the date of enactment of this act and ending on december 31, 2019. notwithstanding any provision of this act, payments and other actions for adjustments to any obligations incurred for plan years 2018 and 2019 may be made through december 31, 2020. section 205, repeal of cost-sharing subsidy program. a, in general, section 1402 of the patient protection and affordable care act 42-usc-18071 is repealed. b, effective date, the repeal made by subsection a shall apply
a senator: mr. president? the presiding officer: the senator from wyoming. mr. enzi: i ask unanimous consent that for the duration of the senate's consideration of h.r. 1628, the majority and democratic managers of the bill while seated or standing at the managers' desks be permitted to deliver floor remarks, retrieve, review, and edit documents, and send e-mail and other data communications from texts displayed on wireless personal, digital assistance devices and tablet devices. the presiding officer: is there objection? without objection. mr. enzi: i ask unanimous consent that the use of calculators be permitted on the floor during the consideration of h.r. 1628. the presiding officer: without objection. mr. enzi: i further ask unanimous consent that paul vinavinich and greg deanglo from my staff be given all access passes to the floor and roger tiffany, sean ross and sam
safari, interns for the budget committee be granted floor privileges during the consideration of h.r. 1628. the presiding officer: without objection. mr. enzi: mr. president, what is the regular order with respect to the pending amendment? the presiding officer: two hours equally divided. mr. enzi: thank you, mr. president. i'd suggest the absence of a quorum and ask that the time be equally divided. the presiding officer: is there objection? without objection. mrs. murray: objection end i'd suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: